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BATON ROUGE, La. (AP) — U.S. Sen. Mary Landrieu said Wednesday that the resistance of Republican state leaders to the Affordable Care Act was “hurting people” by making it more difficult to carry out the insurance changes required by the federal health care law.

“Part of the problem is that the state — despite the fact that it’s the law, despite the fact that the Supreme Court upheld it — is dragging its feet, and it’s only hurting the citizens. It’s just hurting people,” Landrieu said after giving a speech to the local Rotary Club.

Landrieu continued her defense of the federal law, supporting a signature policy of President Barack Obama that Republicans believe can help them defeat the Democratic senator in the 2014 election. The National Republican Senatorial Committee launched a new TV ad Wednesday attacking Landrieu for backing the law, among other policies of the president.

Landrieu said Republican Gov. Bobby Jindal’s administration should have taken the lead in creating the mandated health insurance marketplace for people who don’t qualify for Medicaid to shop for coverage, rather than letting the federal government establish and run it.

But the senator also acknowledged that federal officials are having difficulty getting the online insurance marketplaces, called exchanges, set up by the Oct. 1 deadline.

“Of course the federal government’s struggling. It would have been a lot easier and better for everybody had the state set up the exchange, but they punted. They didn’t want to, so now the federal government’s scrambling to set it up,” she said.

Jindal, a possible Republican presidential candidate in 2016, opposed the Affordable Care Act and wants the law repealed, calling it too costly, unworkable and an improper expansion of government.

In addition to rejecting a state-run exchange, Jindal has refused to expand the state’s Medicaid program as allowed under the law, though the federal government would fully cover the initial costs of providing coverage to as many as 400,000 uninsured people in Louisiana.

The nonpartisan Legislative Fiscal Office estimates the Medicaid expansion could save Louisiana as much as $510 million over 10 years, with the state receiving up to $15 billion in federal funding. The Jindal administration disputes the numbers, saying the expansion could cost the state up to $1.7 billion over a decade.

Landrieu, expected to face a tough re-election battle next year, said the federal health care overhaul will offer people a better insurance system, though she said the benefits may be “slower-going” to show up in Louisiana.

Her defense of the federal law came in questions asked by reporters. She didn’t mention the Affordable Care Act during her speech to the Rotary Club of Baton Rouge, instead focusing on coastal protection efforts, flood insurance rates and community planning.

In her third term, Landrieu is considered vulnerable because she is a Democrat in a state that tends to vote Republican in national elections.

Two Republicans are running against her for the Senate seat so far: U.S. Rep. Bill Cassidy, a doctor from Baton Rouge, and Rob Maness, a retired Air Force colonel and tea party supporter from Madisonville.